AI Article Synopsis

  • Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19, developing around 4 weeks after infection, characterized by hyperinflammation and potential shock.* -
  • The European Academy of Allergy and Clinical Immunology formed a task force to create guidelines for diagnosing, treating, and monitoring MIS-C, focusing on its unclear immunological mechanisms.* -
  • Current treatment involves supportive care and immunosuppressive agents like steroids, and regular follow-ups are essential to monitor for complications, with vaccination against COVID-19 shown to help prevent MIS-C.*

Article Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.

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http://dx.doi.org/10.1111/pai.13900DOI Listing

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